How does Wrong Site Surgery Happen? Part 1

Everyone know someone who has had surgery. But did you know that breakdowns in the surgical care process can happen at many points? Procedures are in place to match the patient's arm band with verbally asking the patient what their birth date is to insure it is the correct patient. The surgeon marks the patient prior to arriving in the OR. OR staff is responsible to insure the appropriate consent form indicates the body part the surgeon has marked prior to induction of anesthesia. The area is then prepped and the surgeon's initials should still remain after preparation for surgery to indicate the site. At every point in the process there is a possibility of error.

The actions of the surgeon in the OR are a huge determinant of whether wrong site surgery occurs; surgeons have control of the actual incisions and procedures performed. Despite having all the right consent forms and procedures outlined, ultimately control lies in the hands of the surgeon. With that being said, incidence of wrong site surgery increases with transfer of patients from one surgeon to another as well as having multiple surgeons operating at one time.

The Joint Commission states the root cause analysis (RCA) of wrong site surgeries are that:
1. Time out procedures aren't performed
2. Not verifying consents or site markings
3. Inaccurate consents/diagnostic reports/images,
4. Patient's positioning can be determinants as well. Larger patients/obese patients make positioning of the equipment slightly different than what normally happens in the OR.

Related Articles:
Wrong Site Surgery is a Never Event
Despite efforts to avert - Wrong Site Surgery still occurs

Sugar, Sugar everywhere but how much do we need?

We all know what sugar is, but do we really know where how we can find it in our daily meals? Sugar is a carbohydrate that is a source of energy for our bodies. It comes in all sorts of forms;

Fructose is found in fruit

Glucose in animal products

Lactose in milk

According to the Dietary Guidelines for Americans, a person with a 2000 calorie diet can have 267 calories of - approximately 8 teaspoons a day.

But where are these actually found?
Aside from naturally being in some foods, it is put into most processed foods. And it's everywhere. I was shocked to find it in a can of Kidney Beans. where it is listed as the second ingredient on the can, High Fructose Corn Syrup. By adding this into virtually any processed food, even salad dressings, it's added to the prevalence of obesity and diabetes plaguing our nation. And with our diet consisting of many processed foods, it gets harder and harder to track down how much sugar we are consuming everyday.

Important Tip: Take in some complex carbs instead.

These consists of fruits, green leafy vegetables, pastas, grains and other foods.
By taking in these types of carbs, our body uses almost 25 times more energy to try to store this as fat as opposed to simple sugars which require almost no energy whatsoever to convert and provide almost no nutritional value.

Have you found sugar added to something that surprised you?

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How much water should you drink each day?

Do you know how much water you drink on any given day? A glass here or there, perhaps left half empty on the coffee table when we headed up to bed. Do you negotiate with yourself: well I had one glass of water, but I had 2 cups of coffee and a really juicy apple so that should do it? If you really stop to think about it, you probably haven't had that recommended 8 glasses of water a day. But is that all our bodies need?

Our bodies are about 66% water, depending on activity level and diet. We depend on water to flush out toxins in our bodies, keep natural bodily reactions going, and as a temperature regulator. When we have too much fat in our diet, and not enough water, we tend to find our temperature irregular usually on the warm side. For an average adult woman, you need about 11 cups of water a day. We get some of this through our food intake, but still you need to drink about 9 glasses a day.Aside from the sugar and sodium intake from these beverages, caffeine in coffee and soft drink acts as a diuretic, causing our body to flush water out quicker than it can be used. So next time you reach for a can of Mountain Dew, step back and think.....how much water have I actually had today?